P. Gupta, Saurav Lamichane, H. Bhatia, M. Singhal, Vishal Sharma, Harjeet Singh, Rajender Kumar, M. Sandhu
Abstract Small bowel tumors are rare with nonspecific and protean clinical presentation. Early diagnosis of small bowel tumors is desirable as they can be associated with significant morbidity. In malignant small bowel tumors, delayed diagnosis may result in dissemination and metastasis leading to poor clinical outcomes. Imaging evaluation of small bowel can be challenging due to unpredictable luminal distension, peristalsis, and motion. In addition, the lack of distinction between the intraluminal lesions and intraluminal contents can be difficult at times. Computed tomography (CT) and magnetic resonance (MR) enterography are the most common imaging techniques for the evaluation of small bowel tumors. While these techniques may not be able to detect small tumors, they provide comprehensive evaluation of lumen, wall, and extramural structures in tumors more than 2 cm. Acquaintance of imaging appearance of common benign and malignant small bowel tumors may allow improved detection during evaluation of CT and MR enterography studies. In this review, we discuss the imaging appearances, approach, and differential diagnosis of small bowel tumors on cross-sectional imaging studies.
{"title":"Imaging of Small Bowel Tumors and Mimics","authors":"P. Gupta, Saurav Lamichane, H. Bhatia, M. Singhal, Vishal Sharma, Harjeet Singh, Rajender Kumar, M. Sandhu","doi":"10.1055/s-0043-1770964","DOIUrl":"https://doi.org/10.1055/s-0043-1770964","url":null,"abstract":"Abstract Small bowel tumors are rare with nonspecific and protean clinical presentation. Early diagnosis of small bowel tumors is desirable as they can be associated with significant morbidity. In malignant small bowel tumors, delayed diagnosis may result in dissemination and metastasis leading to poor clinical outcomes. Imaging evaluation of small bowel can be challenging due to unpredictable luminal distension, peristalsis, and motion. In addition, the lack of distinction between the intraluminal lesions and intraluminal contents can be difficult at times. Computed tomography (CT) and magnetic resonance (MR) enterography are the most common imaging techniques for the evaluation of small bowel tumors. While these techniques may not be able to detect small tumors, they provide comprehensive evaluation of lumen, wall, and extramural structures in tumors more than 2 cm. Acquaintance of imaging appearance of common benign and malignant small bowel tumors may allow improved detection during evaluation of CT and MR enterography studies. In this review, we discuss the imaging appearances, approach, and differential diagnosis of small bowel tumors on cross-sectional imaging studies.","PeriodicalId":52666,"journal":{"name":"Journal of Gastrointestinal and Abdominal Radiology","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89282538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
K. Sathyakumar, A. Chandramohan, A. Eapen, Anuja Abraham
Abstract Background The spectrum of placental adhesive disorders (PAD) forms an important cause for emergency cesarean hysterectomy, requiring an accurate prenatal diagnosis for optimal obstetric management. Purpose The aim of this study was to assess the utility of magnetic resonance imaging (MRI) and to identify the individual MRI features that are most useful in the evaluation of PAD. Materials and Methods This was a retrospective review of the MRI of 24 women with abnormal placentation, confirmed using histopathology/intraoperative findings as the reference standard. Patients were categorized as negative or positive for PAD (placenta accreta, increta, and percreta) on MRI and compared with the reference standard. We assessed the diagnostic performance of MRI and the features that best correlated with the presence of PAD. Results Among the 24 women (mean age: 29.8 years) with risk factors, 16 had PAD (6 accreta, 7 increta, and 3 percreta). There was a history of previous lower segment cesarean section and placenta previa in 14 (87.5%). MRI could identify the presence of PAD in all (100% sensitivity) and its absence in three out of eight patients (37.5% specificity). The features with highest sensitivity were intraplacental dark bands (100%), myometrial thinning/loss of interface with myometrium (100%), placental heterogeneity (75%), and uterine contour abnormality (75%). Conclusion MRI is an important modality for the investigation of PAD in suspected cases, with excellent sensitivity and good accuracy. Identifying the presence of risk factors, low-signal-intensity bands, and thinning/loss of placental–myometrial interface will aid in its diagnosis.
{"title":"Diagnostic Value of MRI in Placental Adhesive Disorders in Pregnancy","authors":"K. Sathyakumar, A. Chandramohan, A. Eapen, Anuja Abraham","doi":"10.1055/s-0043-1768643","DOIUrl":"https://doi.org/10.1055/s-0043-1768643","url":null,"abstract":"Abstract Background The spectrum of placental adhesive disorders (PAD) forms an important cause for emergency cesarean hysterectomy, requiring an accurate prenatal diagnosis for optimal obstetric management. Purpose The aim of this study was to assess the utility of magnetic resonance imaging (MRI) and to identify the individual MRI features that are most useful in the evaluation of PAD. Materials and Methods This was a retrospective review of the MRI of 24 women with abnormal placentation, confirmed using histopathology/intraoperative findings as the reference standard. Patients were categorized as negative or positive for PAD (placenta accreta, increta, and percreta) on MRI and compared with the reference standard. We assessed the diagnostic performance of MRI and the features that best correlated with the presence of PAD. Results Among the 24 women (mean age: 29.8 years) with risk factors, 16 had PAD (6 accreta, 7 increta, and 3 percreta). There was a history of previous lower segment cesarean section and placenta previa in 14 (87.5%). MRI could identify the presence of PAD in all (100% sensitivity) and its absence in three out of eight patients (37.5% specificity). The features with highest sensitivity were intraplacental dark bands (100%), myometrial thinning/loss of interface with myometrium (100%), placental heterogeneity (75%), and uterine contour abnormality (75%). Conclusion MRI is an important modality for the investigation of PAD in suspected cases, with excellent sensitivity and good accuracy. Identifying the presence of risk factors, low-signal-intensity bands, and thinning/loss of placental–myometrial interface will aid in its diagnosis.","PeriodicalId":52666,"journal":{"name":"Journal of Gastrointestinal and Abdominal Radiology","volume":"16 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87952067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dear readers, Welcome to this special issue of Journal of Gastrointestinal and Abdominal Radiology (JGAR). Our concepts of hepatic pathophysiology have advanced tremendously in the recent times, as for example, with the understanding of the different types of hepatic adenomas or the role of organic anion transporting polypeptides receptor for hepatobiliary contrast uptake.Hepatic imaging concepts and techniqueshavealsomade tremendous strides. In fact, a vast majority of hepatic lesions can now be diagnosed on imaging alone, be it cysts, hemangiomas, focal nodular hyperplasia, hepatocellular carcinoma, or cholangiocarcinomas. With the addition of contrast-enhanced ultrasound and hepatobiliary magnetic resonance (MR) contrast to our armory, we have got even better at problem-solving while characterizing hepatic lesions. It was, thus, appropriate to have a series of dedicated issues focused on liver imaging, contextualizing the literature to our population. Our gratitude goes to the Editor-inChief for providing us with the opportunity to curate these articles. Volume 1 deals with the essentials of hepatic imaging and with noncirrhotic liver pathologies, while volume 2 focuses more on cirrhotic liver pathology. In this volume, we first begin with the basics, as Garde and Bhute discuss hepatic anatomy, variants, and imaging techniques with the help of some exquisite images.1 Beyond lesion characterization, giving the surgeon a roadmap in terms of the segmental, vascular, and biliary anatomy is an extremely important task for the radiologist, making this article a must read. Kumar et al then comprehensively discuss an important aspect of hepatic imaging that is difficult to learn from Western textbooks given the difference in patient populations; an approach to hepatic infections in the Indian setting.2 Do not miss their succinct table summarizing the appearance of various infections on imaging! Behera et al meticulously discuss the common benign hepatic neoplasms in the next article, including laying out few extremely useful tables and giving an algorithmic approach to solid hepatic lesions at the end.3 We then move on from neoplasms to vascular hepatic pathologies as Augustine et al discuss an imaging approach to portal hypertension.4 They delve deep into the topic, going beyond the “regular” imaging findings, and going into painstaking detail for each etiology of portal hypertension. This would be particularly useful not just for clinical radiologists but also for exam-going residents. We also feature an excellent prospective study by Rajesh et al, comparing the accuracy of fatty liver estimation on dual-energy computed tomography with MRI evaluation.5 Besides these liver-focused topics, this volume also has two other original articles. Chandramohan et al evaluate a very practical scenario faced by many radiologists reporting an MRI of a rectal mass when the pathology is unknown; should we use the rectal template for adenocarcinoma or squamous cell
{"title":"Special Issue Liver Imaging—Part 1","authors":"A. Baheti, A. Eapen","doi":"10.1055/s-0043-1769785","DOIUrl":"https://doi.org/10.1055/s-0043-1769785","url":null,"abstract":"Dear readers, Welcome to this special issue of Journal of Gastrointestinal and Abdominal Radiology (JGAR). Our concepts of hepatic pathophysiology have advanced tremendously in the recent times, as for example, with the understanding of the different types of hepatic adenomas or the role of organic anion transporting polypeptides receptor for hepatobiliary contrast uptake.Hepatic imaging concepts and techniqueshavealsomade tremendous strides. In fact, a vast majority of hepatic lesions can now be diagnosed on imaging alone, be it cysts, hemangiomas, focal nodular hyperplasia, hepatocellular carcinoma, or cholangiocarcinomas. With the addition of contrast-enhanced ultrasound and hepatobiliary magnetic resonance (MR) contrast to our armory, we have got even better at problem-solving while characterizing hepatic lesions. It was, thus, appropriate to have a series of dedicated issues focused on liver imaging, contextualizing the literature to our population. Our gratitude goes to the Editor-inChief for providing us with the opportunity to curate these articles. Volume 1 deals with the essentials of hepatic imaging and with noncirrhotic liver pathologies, while volume 2 focuses more on cirrhotic liver pathology. In this volume, we first begin with the basics, as Garde and Bhute discuss hepatic anatomy, variants, and imaging techniques with the help of some exquisite images.1 Beyond lesion characterization, giving the surgeon a roadmap in terms of the segmental, vascular, and biliary anatomy is an extremely important task for the radiologist, making this article a must read. Kumar et al then comprehensively discuss an important aspect of hepatic imaging that is difficult to learn from Western textbooks given the difference in patient populations; an approach to hepatic infections in the Indian setting.2 Do not miss their succinct table summarizing the appearance of various infections on imaging! Behera et al meticulously discuss the common benign hepatic neoplasms in the next article, including laying out few extremely useful tables and giving an algorithmic approach to solid hepatic lesions at the end.3 We then move on from neoplasms to vascular hepatic pathologies as Augustine et al discuss an imaging approach to portal hypertension.4 They delve deep into the topic, going beyond the “regular” imaging findings, and going into painstaking detail for each etiology of portal hypertension. This would be particularly useful not just for clinical radiologists but also for exam-going residents. We also feature an excellent prospective study by Rajesh et al, comparing the accuracy of fatty liver estimation on dual-energy computed tomography with MRI evaluation.5 Besides these liver-focused topics, this volume also has two other original articles. Chandramohan et al evaluate a very practical scenario faced by many radiologists reporting an MRI of a rectal mass when the pathology is unknown; should we use the rectal template for adenocarcinoma or squamous cell ","PeriodicalId":52666,"journal":{"name":"Journal of Gastrointestinal and Abdominal Radiology","volume":"100 6 1","pages":"077 - 078"},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86240942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Chandramohan, K. Sathyakumar, Antony Augustine, R. John, B. Simon, Rijo Issac, D. Masih, J. Karunya, T. Ram, Ashish Singh, M. Jesudason, R. Mittal
Abstract Aim Magnetic resonance imaging (MRI) of anorectal malignancy is often reported assuming low rectal adenocarcinoma (LRC). The biopsy may, however, reveal squamous cell carcinoma (SCC). Thus, the aim was to compare the imaging findings of SCC and LRC. Methods This was a retrospective study of patients who underwent staging MRI for anorectal malignancy (<5 cm from the anal verge) for adenocarcinoma or squamous cell carcinoma between 2016 and 2021. Two radiologists blinded to biopsy reviewed MRI. Imaging findings and apparent diffusion coefficient (ADC) values were compared between SCC and LRC. Results We studied 137 patients ( n = 60 SCC, n = 77 LRC) with a mean age of 50.4 (standard deviation: 12.4) years and tumor length of 5.6 ± 1.9 cm. SCC patients were older, and their distal tumor margin was closer to the anal verge (5.3 vs. 22 mm for LRC; p <0.001). T2 intermediate signal and diffusion restriction was seen in 97 and 98.2% of SCC and 75.3 and 77% of LRC, respectively. SCC had lower ADC values (0.910 × 10 −3 mm 2 /s) than LRC (1.126 × 10 −3 mm 2 /s; p < 0.001). But there was no difference in the ADC values when T2 hyperintense tumors were excluded ( p = 0.132). Extramural vascular invasion (EMVI) was more frequent in LRC (35.1 vs. 16.7%; p = 0.013). A combination of distance from the anal verge of less than 11 mm, absent EMVI, and the presence of internal iliac and inguinal nodes had an area under the curve (95% confidence interval) of 0.810 (0.737–0.884). Conclusion ADC values are unhelpful in differentiating SCC and LRC. Tumors closer to anal verge, absence of EMVI, and the presence of inguinal and internal-iliac nodes may point towards SCC.
摘要目的磁共振成像(MRI)诊断肛肠恶性肿瘤常被报道为低位直肠腺癌(LRC)。活检可能显示鳞状细胞癌(SCC)。因此，目的是比较SCC和LRC的影像学表现。方法回顾性研究了2016年至2021年期间接受分期MRI检查的肛肠恶性肿瘤(距肛门边缘<5 cm)腺癌或鳞状细胞癌患者。两名对活检不知情的放射科医生检查了MRI。比较SCC和LRC的影像学表现和表观扩散系数(ADC)值。结果137例患者(60例SCC, 77例LRC)，平均年龄50.4岁(标准差12.4)，肿瘤长度5.6±1.9 cm。SCC患者年龄较大，其远端肿瘤边缘更接近肛门边缘(5.3 vs. LRC为22 mm;p < 0.001)。T2中间信号和扩散限制在SCC和LRC中分别为97%和98.2%和75.3和77%。SCC的ADC值(0.910 × 10−3 mm 2 /s)低于LRC (1.126 × 10−3 mm 2 /s);P < 0.001)。排除T2高信号肿瘤后，ADC值差异无统计学意义(p = 0.132)。外血管侵犯(EMVI)在LRC中更为常见(35.1% vs. 16.7%;P = 0.013)。距肛缘距离小于11mm, EMVI缺失，髂内淋巴结和腹股沟淋巴结存在，曲线下面积(95%可信区间)为0.810(0.737 ~ 0.884)。结论ADC值对SCC和LRC的鉴别无帮助。靠近肛门边缘的肿瘤，EMVI的缺失，腹股沟和髂内淋巴结的存在可能指向SCC。
{"title":"MRI Staging of Anorectal Malignancy—A Reporting Dilemma: Is It Adenocarcinoma or Squamous Cell Carcinoma?","authors":"A. Chandramohan, K. Sathyakumar, Antony Augustine, R. John, B. Simon, Rijo Issac, D. Masih, J. Karunya, T. Ram, Ashish Singh, M. Jesudason, R. Mittal","doi":"10.1055/s-0043-1768486","DOIUrl":"https://doi.org/10.1055/s-0043-1768486","url":null,"abstract":"Abstract Aim Magnetic resonance imaging (MRI) of anorectal malignancy is often reported assuming low rectal adenocarcinoma (LRC). The biopsy may, however, reveal squamous cell carcinoma (SCC). Thus, the aim was to compare the imaging findings of SCC and LRC. Methods This was a retrospective study of patients who underwent staging MRI for anorectal malignancy (<5 cm from the anal verge) for adenocarcinoma or squamous cell carcinoma between 2016 and 2021. Two radiologists blinded to biopsy reviewed MRI. Imaging findings and apparent diffusion coefficient (ADC) values were compared between SCC and LRC. Results We studied 137 patients ( n = 60 SCC, n = 77 LRC) with a mean age of 50.4 (standard deviation: 12.4) years and tumor length of 5.6 ± 1.9 cm. SCC patients were older, and their distal tumor margin was closer to the anal verge (5.3 vs. 22 mm for LRC; p <0.001). T2 intermediate signal and diffusion restriction was seen in 97 and 98.2% of SCC and 75.3 and 77% of LRC, respectively. SCC had lower ADC values (0.910 × 10 −3 mm 2 /s) than LRC (1.126 × 10 −3 mm 2 /s; p < 0.001). But there was no difference in the ADC values when T2 hyperintense tumors were excluded ( p = 0.132). Extramural vascular invasion (EMVI) was more frequent in LRC (35.1 vs. 16.7%; p = 0.013). A combination of distance from the anal verge of less than 11 mm, absent EMVI, and the presence of internal iliac and inguinal nodes had an area under the curve (95% confidence interval) of 0.810 (0.737–0.884). Conclusion ADC values are unhelpful in differentiating SCC and LRC. Tumors closer to anal verge, absence of EMVI, and the presence of inguinal and internal-iliac nodes may point towards SCC.","PeriodicalId":52666,"journal":{"name":"Journal of Gastrointestinal and Abdominal Radiology","volume":"140 1","pages":"138 - 147"},"PeriodicalIF":0.0,"publicationDate":"2023-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78893822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Biliary malignancies arise from anywhere along the biliary tract and broadly encompass gallbladder cancer and cholangiocarcinoma. Surgical resection with curative intent remains the mainstay treatment for biliary tract malignancies, but despite advances in treatment and management over the years, prognosis remains poor. The majority of patients present with nonspecific clinical symptoms and are diagnosed at late-stage disease when surgical resection is no longer an option. In the minority of patients presenting with early-stage disease, it is particularly important to determine accurate radiological staging and take a multidisciplinary approach to determine patients suitable for curative surgical resection. A range of imaging modalities is often used in combination, each providing complementary information to characterize and stage disease. Gallbladder cancer and cholangiocarcinoma are distinct entities and the approach to each of these will be discussed separately.
{"title":"Approach to Biliary Malignancies","authors":"Louise I T Lee, A. Rajesh","doi":"10.1055/s-0043-57253","DOIUrl":"https://doi.org/10.1055/s-0043-57253","url":null,"abstract":"Abstract Biliary malignancies arise from anywhere along the biliary tract and broadly encompass gallbladder cancer and cholangiocarcinoma. Surgical resection with curative intent remains the mainstay treatment for biliary tract malignancies, but despite advances in treatment and management over the years, prognosis remains poor. The majority of patients present with nonspecific clinical symptoms and are diagnosed at late-stage disease when surgical resection is no longer an option. In the minority of patients presenting with early-stage disease, it is particularly important to determine accurate radiological staging and take a multidisciplinary approach to determine patients suitable for curative surgical resection. A range of imaging modalities is often used in combination, each providing complementary information to characterize and stage disease. Gallbladder cancer and cholangiocarcinoma are distinct entities and the approach to each of these will be discussed separately.","PeriodicalId":52666,"journal":{"name":"Journal of Gastrointestinal and Abdominal Radiology","volume":"21 1","pages":"212 - 226"},"PeriodicalIF":0.0,"publicationDate":"2023-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86328181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract The goal of Liver Imaging Reporting and Data System (LI-RADS) is to standardize the lexicon, imaging techniques, interpretation, and reporting of observations in patients with a potential risk for developing hepatocellular carcinoma (HCC), and, consequently, improve communication between radiologists and physicians. LI-RADS diagnostic algorithms are applied to a population “at risk,” follow a stepwise algorithmic approach which categorize and stratify individual observations as HCC, and also assess the likelihood of non-HCC malignancies and tumor in vein. Risk factors for developing HCC have geographical variations, which significantly impact diagnostic and management strategies; however, these variations are not considered in the LIRADS v2018 version. Further, the diagnostic algorithm includes several major and ancillary features, and, tie-breaking rules, which result in numerous probable combinations by which a plausible observation could be assigned a particular category, inherently increasing its complexity. Heterogeneity of the diagnostic algorithm results in certain imaging pitfalls and poses challenges in the precise characterization of observations, complicating its use in routine clinical practice. This article reviews the gray zones which may be encountered in the evaluation of LR-3, LR-M, and LR-TIV observations during routine clinical imaging with contrast-enhanced computed tomography and magnetic resonance imaging.
{"title":"The Gray Zone: LR3, LR-M, and LR-TIV","authors":"K. Ganesan, Shivsamb Jalkote, S. Nellore","doi":"10.1055/s-0043-1764401","DOIUrl":"https://doi.org/10.1055/s-0043-1764401","url":null,"abstract":"Abstract The goal of Liver Imaging Reporting and Data System (LI-RADS) is to standardize the lexicon, imaging techniques, interpretation, and reporting of observations in patients with a potential risk for developing hepatocellular carcinoma (HCC), and, consequently, improve communication between radiologists and physicians. LI-RADS diagnostic algorithms are applied to a population “at risk,” follow a stepwise algorithmic approach which categorize and stratify individual observations as HCC, and also assess the likelihood of non-HCC malignancies and tumor in vein. Risk factors for developing HCC have geographical variations, which significantly impact diagnostic and management strategies; however, these variations are not considered in the LIRADS v2018 version. Further, the diagnostic algorithm includes several major and ancillary features, and, tie-breaking rules, which result in numerous probable combinations by which a plausible observation could be assigned a particular category, inherently increasing its complexity. Heterogeneity of the diagnostic algorithm results in certain imaging pitfalls and poses challenges in the precise characterization of observations, complicating its use in routine clinical practice. This article reviews the gray zones which may be encountered in the evaluation of LR-3, LR-M, and LR-TIV observations during routine clinical imaging with contrast-enhanced computed tomography and magnetic resonance imaging.","PeriodicalId":52666,"journal":{"name":"Journal of Gastrointestinal and Abdominal Radiology","volume":"11 1","pages":"185 - 201"},"PeriodicalIF":0.0,"publicationDate":"2023-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89167935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Liver infections are a common and appropriate management depends on the accurate diagnosis. Imaging is an important part of the workup of patients with suspected liver infections. The imaging appearances depend on the causative agent. When imaging features are seen in context of the clinical presentation, biochemical features, and predisposing condition, a specific diagnosis is possible in a significant proportion of patients. In this review, we discuss the imaging-based approach to liver infections.
{"title":"Radiological Approach to Liver Infections","authors":"Abhinandan Kumar, Dollphy Garg, Pankaj Gupta","doi":"10.1055/s-0043-57014","DOIUrl":"https://doi.org/10.1055/s-0043-57014","url":null,"abstract":"Abstract Liver infections are a common and appropriate management depends on the accurate diagnosis. Imaging is an important part of the workup of patients with suspected liver infections. The imaging appearances depend on the causative agent. When imaging features are seen in context of the clinical presentation, biochemical features, and predisposing condition, a specific diagnosis is possible in a significant proportion of patients. In this review, we discuss the imaging-based approach to liver infections.","PeriodicalId":52666,"journal":{"name":"Journal of Gastrointestinal and Abdominal Radiology","volume":"274 1","pages":"101 - 108"},"PeriodicalIF":0.0,"publicationDate":"2023-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73380576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
R. K. Behera, Stuti Chandola, A. Goyal, Raju Sharma
Abstract Benign liver neoplasms are commonly encountered in clinical practice. Lesions like typical hemangioma may be confidently diagnosed on ultrasound, but for the majority of other liver lesions, multiphasic computed tomography (CT) and magnetic resonance imaging (MRI) are usually warranted. In lesions like adenomas, making the diagnosis alone is not sufficient; rather subcategorization is important to optimally manage these cases. Additionally, commonly observed variant lesions like the inflammatory subtype of hepatocellular adenoma and focal nodular hyperplasia mimic each other, which exacerbates the diagnostic dilemma. When observing cystic lesions, mucinous cystic neoplasm of the liver (MCN-L) needs to be differentiated from the more common non-neoplastic etiologies like hydatid cysts. Radiologists should also be acquainted with features of rare hepatic neoplasms like angiomyolipoma, paraganglioma, and inflammatory pseudotumor. In this review, we discuss the salient features and differentiating points to suggest the most likely diagnosis.
{"title":"Benign Hepatic Neoplasms: An Imaging Review","authors":"R. K. Behera, Stuti Chandola, A. Goyal, Raju Sharma","doi":"10.1055/s-0043-1764378","DOIUrl":"https://doi.org/10.1055/s-0043-1764378","url":null,"abstract":"Abstract Benign liver neoplasms are commonly encountered in clinical practice. Lesions like typical hemangioma may be confidently diagnosed on ultrasound, but for the majority of other liver lesions, multiphasic computed tomography (CT) and magnetic resonance imaging (MRI) are usually warranted. In lesions like adenomas, making the diagnosis alone is not sufficient; rather subcategorization is important to optimally manage these cases. Additionally, commonly observed variant lesions like the inflammatory subtype of hepatocellular adenoma and focal nodular hyperplasia mimic each other, which exacerbates the diagnostic dilemma. When observing cystic lesions, mucinous cystic neoplasm of the liver (MCN-L) needs to be differentiated from the more common non-neoplastic etiologies like hydatid cysts. Radiologists should also be acquainted with features of rare hepatic neoplasms like angiomyolipoma, paraganglioma, and inflammatory pseudotumor. In this review, we discuss the salient features and differentiating points to suggest the most likely diagnosis.","PeriodicalId":52666,"journal":{"name":"Journal of Gastrointestinal and Abdominal Radiology","volume":"355 1","pages":"109 - 122"},"PeriodicalIF":0.0,"publicationDate":"2023-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80116151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract In the past decade or two, there has been a significant change in the epidemiology of liver diseases, such as rise in the incidence of nonalcoholic steatohepatitis, good control of viral load in hepatitis B and C related liver diseases, and revolutionary changes in the treatment of hepatocellular carcinoma. Hence, monitoring of these diseases warrants effective noninvasive imaging techniques. Besides, organ transplantation has evolved to play a major role in the treatment of chronic liver diseases and acute liver failures. With the advent of better technology and new imaging sequences in cross-sectional imaging, there has been a dramatic change in the arena of liver imaging. Knowledge of these imaging modalities and effective application of the existing and new imaging techniques is essential to meet these changing clinical needs. This article aims at revisiting the liver anatomy from a practical stand point and touches upon the key cross-sectional imaging techniques of computed tomography and magnetic resonance imaging with recent advances.
{"title":"Liver Anatomy and Cross-Sectional Imaging Techniques: A Practical Approach","authors":"P. Garde, Rahul Bhagwan Bhute","doi":"10.1055/s-0043-1767727","DOIUrl":"https://doi.org/10.1055/s-0043-1767727","url":null,"abstract":"Abstract In the past decade or two, there has been a significant change in the epidemiology of liver diseases, such as rise in the incidence of nonalcoholic steatohepatitis, good control of viral load in hepatitis B and C related liver diseases, and revolutionary changes in the treatment of hepatocellular carcinoma. Hence, monitoring of these diseases warrants effective noninvasive imaging techniques. Besides, organ transplantation has evolved to play a major role in the treatment of chronic liver diseases and acute liver failures. With the advent of better technology and new imaging sequences in cross-sectional imaging, there has been a dramatic change in the arena of liver imaging. Knowledge of these imaging modalities and effective application of the existing and new imaging techniques is essential to meet these changing clinical needs. This article aims at revisiting the liver anatomy from a practical stand point and touches upon the key cross-sectional imaging techniques of computed tomography and magnetic resonance imaging with recent advances.","PeriodicalId":52666,"journal":{"name":"Journal of Gastrointestinal and Abdominal Radiology","volume":"9 1","pages":"089 - 100"},"PeriodicalIF":0.0,"publicationDate":"2023-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75229816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Antony Augustine, R. John, B. Simon, A. Chandramohan, S. Keshava, A. Eapen
Abstract Increase in portal venous pressure (termed portal hypertension) is seen in a variety of liver diseases. Imaging tests are useful to detect portal hypertension and identify its cause. Noninvasive tests like abdominal ultrasound and Doppler studies are routinely done in clinical practice for this indication. Cross-sectional studies like computed tomography and magnetic resonance imaging are especially useful to delineate morphological abnormalities in the liver. Invasive tests like assessment of hepatic venous pressure gradient are done less frequently for specific indications. Distinctive imaging findings help differentiate the different causes of portal hypertension like cirrhosis and vascular liver disorders like noncirrhotic portal hypertension, extrahepatic portal venous obstruction, and Budd–Chiari syndrome. Radiological interventions are increasingly used to treat complications of portal hypertension like refractory ascites or refractory bleeding from gastroesophageal varices.
{"title":"Imaging Approach to Portal Hypertension","authors":"Antony Augustine, R. John, B. Simon, A. Chandramohan, S. Keshava, A. Eapen","doi":"10.1055/s-0043-1764311","DOIUrl":"https://doi.org/10.1055/s-0043-1764311","url":null,"abstract":"Abstract Increase in portal venous pressure (termed portal hypertension) is seen in a variety of liver diseases. Imaging tests are useful to detect portal hypertension and identify its cause. Noninvasive tests like abdominal ultrasound and Doppler studies are routinely done in clinical practice for this indication. Cross-sectional studies like computed tomography and magnetic resonance imaging are especially useful to delineate morphological abnormalities in the liver. Invasive tests like assessment of hepatic venous pressure gradient are done less frequently for specific indications. Distinctive imaging findings help differentiate the different causes of portal hypertension like cirrhosis and vascular liver disorders like noncirrhotic portal hypertension, extrahepatic portal venous obstruction, and Budd–Chiari syndrome. Radiological interventions are increasingly used to treat complications of portal hypertension like refractory ascites or refractory bleeding from gastroesophageal varices.","PeriodicalId":52666,"journal":{"name":"Journal of Gastrointestinal and Abdominal Radiology","volume":"2010 1","pages":"123 - 137"},"PeriodicalIF":0.0,"publicationDate":"2023-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86310229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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